Provider Demographics
NPI:1043833700
Name:VALDEZ ESPINOZA, MARCO ANTONIO (MD)
Entity Type:Individual
Prefix:MR
First Name:MARCO
Middle Name:ANTONIO
Last Name:VALDEZ ESPINOZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:MARCO
Other - Middle Name:ANTONIO
Other - Last Name:VALDEZ ESPINOZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4949 N 7TH STREET, APARTMENT 348
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014
Mailing Address - Country:US
Mailing Address - Phone:312-792-6892
Mailing Address - Fax:
Practice Address - Street 1:500 W. THOMAS ROAD
Practice Address - Street 2:#901 DEPARTMENT OF INTERNAL MEDICINE
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013
Practice Address - Country:US
Practice Address - Phone:602-406-5430
Practice Address - Fax:602-406-5430
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-28
Last Update Date:2022-07-22
Deactivation Date:2022-02-10
Deactivation Code:
Reactivation Date:2022-03-16
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program